Indications of Primary Cesarean Section In Multipara

Abstract

Objective: To evaluate the indications of primary cesarean section in multipara and to assess the obstetric outcome including maternal, fetal morbidity and mortality, perinatal outcome. Study Design and Setting: It was a hospital based study of primary caesarean sections (CS) done on multiparous patients in duration of two years between January 1, 2016, and December 2017 at Jinnah medical college hospital Karachi. Methodology: Multiparous patients were those who had delivered through vaginal route one or more times (i.e. 28 weeks of gestation or above) or had 1–4children and grand-multiparous are those who had 5 or more children. All the cases included in the study were hospital based and cesarean section was decided by specialist. The procedure was performed by registrars and specialists. The selected patients were followed up till they were discharge from the ward with minimum hospital stay of three days. Data was compiled and results were carried out by SPSS version 23. Results: During the two years of study period, the number of total deliveries were 2064. The primary CS rate in multipara was 37.17%. These women have more likely to have an emergency cessarean sections compared to elective i.e. 85% and15%. The mean age of women was 29.5 years, booked cases were 72.5% and unbooked were 27.5%. Regarding indications for cesarean sections, non-progress of labour ranked first 25.5% followed by fetal distress 20%, pre eclampsia 12 % and ante partum hemorrhage 10.5% etc. Increase incidence of morbidity and mortality was seen in patients undergoing cesarean section due to different reasons. Conclusion: Primary caesarean sections in multipara comprise only a small percentage (37.17%) of total deliveries but were related to high maternal and fetal morbidity

Out of sight, out of mind? Evidence from cross-sectional surveys on hidden caesarean sections among women with stillbirths in Ghana, 2007 and 2017

“…This difference might be explained by differing indications for CS between nulliparous and multiparous women. Considering all CS performed in nulliparous, most are due to prolonged labour, while in multiparous women higher percentages are due to (pre)eclampsia, placental abruption and placenta praevia 38. The latter indications have higher risks of SBVEND.…”

“…Considall CS performed in nulliparous, most are due to prolonged labour, while in multiparous women higher percentages are due to (pre)eclampsia, placental abruption and placenta praevia. 38 The latter indications have higher risks of SBVEND.…”

Primary Caesarean Section among Multiparous Pregnant Women Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…In this study, most of the patients 40% belong to 2125 years followed by 34.19% in the 26-30 years age group similar to the study done in Andhra Pradesh and Vijayawada 11 , 12 and contrast to the study done at Karachi. 13 Maximum number of cases were unbooked (90.32%), and this led to ignorance of antenatal checkup in cases of multigravidas.…”

“…14 The operation performed was lower segment caesarean section with emergency caesarean 96.12% and elective 3.87% which is similar to the study done in Karachi. 13 The caesarean hysterectomy was done in 1.93% of cases for rupture uterus and hand prolapse. The most common cases of primary caesarean in parous women were fetal distress (40.63%), non-progress of labour and breech (7.74%), and oligohydramnios (7.09%) similar to other studies.…”

Non-obstetric Causes of Cesarean Section in Iranian Pregnant Women Referring to Medical Services Commission

“…The rate of severe complications in planned CS, compared to planned vaginal delivery, has been reported three times (8), which will also increase treatment costs (9). Given the higher rates of maternal morbidity and mortality associated with CS, it is, therefore, necessary to evaluate the indications and maternal and neonatal outcomes associated with CS (10). In addition to medical and non-medical causes, in recent studies, some factors such as high social class (11), delivery by the doctor and the desired time (12,13), greater awareness of women about their rights to make decisions for their health issues, traumatic experiences in previous pregnancies (14) were studied.…”